Meningococcal Conjugate Vaccine MCV4

Meningococcal Conjugate Vaccine MCV4 Brand Names- Menactra | Menveo

What is Meningococcal Conjugate Vaccine MCV4

The meningococcal vaccine is available as 4 different formulations: meningococcal polysaccharide vaccine (Menomune); meningococcal polysaccharide diphtheria toxoid conjugate vaccine (Menactra); meningococcal oligosaccharide diphtheria toxoid conjugate vaccine (Menveo); meningococcal recombinant vaccine (Trumenba and Bexsero).

All 4 vaccines are indicated for the prevention of invasive disease caused by Neisseria meningitidis; Menomune, Menactra, and Menveo are active against serogroups A, C, Y, and W-135, while Trumenba and Bexsero are active against serogroup B.

Meningococcal disease is a result of an invasive infection by N. meningitidis; the 5 main N. meningitidis serogroups responsible for meningococcal disease are A, B, C, Y, or W-135.

Although relatively uncommon in the U.S., meningococcal disease is fatal in approximately 10% to 15% of patients despite appropriate antibiotic therapy, with an additional 10% to 20% experiencing permanent complications (brain damage and limb loss).

Individuals at increased risk for meningococcal disease include infants and children younger than 5 years, adolescents and young adults 16 to 21 years, and the elderly.

Meningococcal polysaccharide diphtheria toxoid conjugate vaccine (Menactra) and meningococcal oligosaccharide diphtheria toxoid conjugate vaccine (Menveo) are intramuscularly administered vaccines for the prevention of disease caused by N. meningitidis serogroups A, C, Y, and W-135.

These vaccines produce similar immune responses for all 4 serogroups as the non-conjugated polysaccharide vaccine (Menomune); however, the conjugated vaccines are more likely to prime immunologic memory because the 4 serogroups are individually conjugated to diphtheria toxoid protein.

Thus, the conjugate vaccines are expected to provide a longer duration of immunity towards meningococcal disease and may provide herd immunity through protection from nasopharyngeal carriage.

As a result, meningococcal conjugate vaccines have largely replaced the use of the non-conjugate polysaccharide vaccine, and is preferred for younger adults, adolescents, children and select infants in noted risk groups; however, these vaccines are not approved for use in patients 55 years of age and older.

The non-conjugated polysaccharide vaccine remains the only licensed meningococcal vaccine approved for use in adults 56 years or older.

Routine vaccination is recommended for adolescents 11 to 18 years of age, preferably with 1 dose of a meningococcal conjugate vaccine at age 11 or 12 years, and a booster dose at 16 years; booster doses may be indicated for individuals who remain at continued risk.

Indications

  • meningococcal infection prophylaxis

General Dosing Information

Routine Immunization

  • Routine vaccination of all persons 11 to 18 years of age, preferably at age 11 or 12 years, with 1 dose of MCV4 (Menveo or Menactra) is recommended by the Advisory Committee on Immunization Practices.
  • A booster dose at age 16 years is recommended if the primary dose was given at age 11 or 12 years. If the primary dose was given at age 13 to 15 years, give a booster dose at age 16 to 18 years. No booster dose is needed if the primary dose was given on or after age 16 years.
  • Pediatric patients who have received Hib-MenCY-TT (MenHibrix), MCV4, or both, prior to their 10th birthday should still receive the routinely recommended doses at age 11 to 12 years and 16 years. For children whom boosters are recommended, follow the booster schedule for patients at increased risk.

Side Effects

  1. anaphylactic shock
  2. anaphylactoid reactions
  3. angioedema
  4. anorexia
  5. arthralgia
  6. chills
  7. diarrhea
  8. dizziness
  9. drowsiness
  10. dyspnea
  11. erythema
  12. fatigue
  13. fever
  14. Guillain-Barre syndrome
  15. headache
  16. hypotension
  17. inconsolable crying
  18. injection site reaction
  19. irritability
  20. lymphadenopathy
  21. malaise
  22. myalgia
  23. myelitis
  24. nausea
  25. paresthesias
  26. pruritus
  27. rash
  28. syncope
  29. urticaria
  30. vomiting
  31. wheezing

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • agammaglobulinemia
  • anticoagulant therapy
  • breast-feeding
  • chemotherapy
  • coagulopathy
  • fever
  • geriatric
  • Guillain-Barre syndrome
  • hemophilia
  • human immunodeficiency virus (HIV) infection
  • hypogammaglobulinemia
  • immunosuppression
  • infants
  • infection
  • neonates
  • neoplastic disease
  • pregnancy
  • premature neonates
  • radiation therapy
  • severe combined immunodeficiency (SCID)
  • syncope
  • thrombocytopenia
  • vitamin K deficiency

Interactions

  • Ocrelizumab
  • Siponimod